Individual
MICHELLE ROSS WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2200 WASHINGTON ST, PADUCAH, KY 42003-3256
(270) 558-0450
(270) 558-0452
Mailing address
PO BOX 497, AUGUSTA, AR 72006-0497
(870) 347-2534
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
3003898
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100077530
—
KY
Enumeration date
12/11/2006
Last updated
01/21/2026
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